Evidence map›Paper›PMID 37357788›Full record

SynthesisExpert review of clinical immunology

Epinephrine treatment of food-induced and other cause anaphylaxis in United States and Canadian Emergency Departments: a systematic review and meta-analysis.

Geneva D Mehta, Joumane El Zein, Isis Felippe Baroni, Myrha Qadir, Carol Mita, Rebecca E Cash, Carlos A Camargo

Open access · greenAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Expert review of clinical immunology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. [How I treat anaphylaxis in children].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Geneva D MehtaDepartment of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Joumane El ZeinDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
Isis Felippe BaroniDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
Myrha QadirDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
Carol MitaHarvard Medical School Countway Library, Boston, MA, USA.ORCID 0000-0003-3059-1369
Rebecca E CashDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
Carlos A CamargoDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.ORCID 0000-0002-5071-7654
Massachusetts General Hospital · USBrigham and Women's Hospital · USHarvard University · US

Funding

IMMUNOLOGIC BASIS OF RESISTANCE AND HYPERSENSITIVITYT32AI007306 · NIAID · BRIGHAM AND WOMEN'S HOSPITAL · PI Nora Amanda Barrett, Joshua A Boyce · 1985 to 2026
$12.2M
NIAID NIH HHS T32 AI007306
6 · The paper itself

Abstract

introductionStudies from more than 10 years ago showed epinephrine treatment of food-induced anaphylaxis in the emergency department (ED) was unacceptably low. We investigated whether epinephrine treatment of food-induced and other cause anaphylaxis in United States and Canadian EDs has changed over time.

methodsGuided by a health sciences librarian, we performed a systematic search in Medline, Embase, and Web of Science on 11 January 2023. We included observational studies that reported epinephrine use to treat anaphylaxis in the ED. We stratified by anaphylaxis etiology (food-, venom-, medication-induced, or any cause). Associations between year and epinephrine use were tested using Spearman correlation and proportional meta-analysis.

resultsOf 2458 records identified in our initial search, 40 met inclusion criteria. Of these, 14 examined food-induced, 4 venom-induced, 0 medication-induced, and 24 any cause anaphylaxis. For epinephrine treatment of food-induced anaphylaxis in the ED, among studies using similar definition of anaphylaxis, meta-analysis showed a pooled value of 20.7% (95% CI 17.8, 23.8) for studies performed >10 years ago and 45.1% (95% CI 38.4, 52.0) from those in the last 10 years. For anaphylaxis of any cause, there was no change over time, with a pooled value of 45.0% (95% CI 39.8, 50.3) over the last 10 years. DISCUSSION: Epinephrine treatment of food-induced anaphylaxis in the ED has increased over time. There was no clear change for anaphylaxis of any cause. Over the last 10 years, approximately 45% of ED patients with anaphylaxis received epinephrine. A limitation of the evidence is heterogeneity in anaphylaxis definitions.

Indexed as

AnaphylaxisFood HypersensitivityAllergensCanadaEmergency Service, HospitalEpinephrineHumansRetrospective StudiesUnited StatesAllergensEpinephrineAnaphylaxisepinephrinefood-induced anaphylaxismeta-analysisproportionsystematic reviewtreatment

Identifiers

PMID37357788
PMCPMC10528278
OpenAlexW4382011832

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.